This article reviews research on the relationship between cardiovascular disease (CVD) and obesity. A preponderance of evidence strongly suggests that obesity is causally related to elevated blood pressure, elevated cholesterol, and glucose intolerance, all of which are primary risk factors for CVD. Nevertheless, data linking obesity to CVD itself are less consistent. While some studies show a positive and graded relationship between obesity and CVD incidence and mortality, others show no effect or even an inverse relationship. Possible reasons for these conflicting findings are discussed. These include heterogeneity of obesities, particularly central versus peripheral obesity; misclassification of individuals due to use of inaccurate obesity indices; analytic difficulties in estimating the contributions of obesity as a single variable in a complex chain of causation; and the presence of confounders such as cigarette smoking that lower weight, but are themselves a cause of CVD.

中文翻译：

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肥胖是心血管疾病的危险因素吗？

本文回顾了心血管疾病（CVD）与肥胖之间关系的研究。大量证据强烈表明，肥胖与血压升高、胆固醇升高和葡萄糖不耐症有因果关系，所有这些都是心血管疾病的主要危险因素。然而，将肥胖与心血管疾病本身联系起来的数据不太一致。虽然一些研究表明肥胖与心血管疾病发病率和死亡率之间存在正相关和分级关系，但其他研究则没有显示任何影响，甚至是负相关。讨论了这些相互矛盾的发现的可能原因。其中包括肥胖的异质性，特别是中心性肥胖与周围性肥胖；由于使用不准确的肥胖指数而对个人进行错误分类；评估肥胖作为复杂因果链中单个变量的贡献时存在分析困难；吸烟等混杂因素的存在会降低体重，但其本身就是心血管疾病的一个原因。